“Previously, the policy has addressed restrictions on “family planning assistance” funds. However, Trump’s iteration of the policy has been written to include “global health assistance” funds. Additionally, rather than just being addressed to the Secretary of State and the administrator of USAID, Trump’s memorandum also calls on the Secretary of Health and Human Services to carry out the policy.”

“This is unprecedented, it’s unusual, and frankly it’s cruel,” Rucks tells Bustle. “This is nearly 15 times more funding that is being implicated by Trump’s global gag rule and then expand that out to the millions more women and families that will be implicated.”

And with the addition of the influence of the Department of Health and Human Services, the Global Gag Rule will now have authority over funds controlled by the Center of Disease Control, the National Institutes of Health, and the Food and Drug Administration.

“When you talk about all of the countries that receive U.S. global health assistance, you’re talking about 60 countries,” Rucks says. “And that’s also a phenomenal amount of implementers now who are going to have to comply this expanded gag rule.”